» Articles » PMID: 32655740

Use of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in COVID-19

Overview
Journal J Clin Med Res
Specialty General Medicine
Date 2020 Jul 14
PMID 32655740
Citations 98
Authors
Affiliations
Soon will be listed here.
Abstract

Background: As the pandemic of coronavirus disease 2019 (COVID-19) continues, prognostic markers are now being identified. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are easily accessible values that have been known to correlate with inflammation and prognosis in several conditions. We used the available data to identify the association of NLR and PLR with the severity of COVID-19.

Methods: A literature search using EMBASE, MEDLINE, and Google Scholar for studies reporting the use of NLR and PLR in COVID-19 published until April 28, 2020, was performed. Random effects meta-analysis was done to estimate standard mean difference (SMD) of NLR and PLR values with 95% confidence interval (CI) between severe and non-severe COVID-19 cases.

Results: A total of 20 studies with 3,508 patients were included. Nineteen studies reported NLR values, while five studies reported PLR values between severe and non-severe COVID-19 patients. Higher levels of NLR (SMD: 2.80, 95% CI: 2.12 - 3.48, P < 0.00001) and PLR (SMD: 1.82, 95% CI: 1.03 - 2.61, P < 0.00001)) were seen in patients with severe disease compared to non-severe disease.

Conclusions: NLR and PLR can be used as independent prognostic markers of disease severity in COVID-19.

Citing Articles

Comparison of Platelet Indices, Lymphocyte, and Systemic Inflammation Indices on Days 1 and 8 in Surviving and Non-Surviving COVID-19 Patients at Hasan Sadikin General Hospital, Bandung, Indonesia.

Harti G, Maulida S, Susandi E, Fadjari T, Sumardi U, Alisjahbana B J Blood Med. 2025; 16:61-74.

PMID: 39926111 PMC: 11806915. DOI: 10.2147/JBM.S499023.


Neutrophil-to-Lymphocyte and Platelet Ratio (N/LP Ratio), a Reliable Criterion for Predicting In-Hospital Mortality in Both Genders Infected With SARS-CoV-2.

Mohammadshahi J, Ghobadi H, Shargi A, Moradkhani H, Rezaei H, Kazemy M Mediators Inflamm. 2025; 2024:5720709.

PMID: 39759900 PMC: 11699982. DOI: 10.1155/mi/5720709.


Unveiling the hidden link: elevated platelets and T cell subsets in 5% of moderate COVID-19 patients 48 days post-onset.

An H, Li T, Yang L, Zhang X, Hu H, Zhang C Front Cell Infect Microbiol. 2024; 14:1498491.

PMID: 39628664 PMC: 11611820. DOI: 10.3389/fcimb.2024.1498491.


Evaluation of Inflammatory Markers in Patients with COVID-19 Combined with Type 2 Diabetes Mellitus.

Li J, Zhang Y, Wu R, Ma G, Sheng L, Feng Y Risk Manag Healthc Policy. 2024; 17:2535-2545.

PMID: 39479559 PMC: 11523978. DOI: 10.2147/RMHP.S490281.


The relationship between neutrophil/lymphocyte ratio, platelet/neutrophil ratio, and risk of urosepsis in patients who present with ureteral stones and suspected urinary tract infection.

Villanueva-Congote J, Hinojosa-Gonzalez D, Segall M, Eisner B World J Urol. 2024; 42(1):596.

PMID: 39466513 DOI: 10.1007/s00345-024-05229-1.


References
1.
Angkananard T, Anothaisintawee T, McEvoy M, Attia J, Thakkinstian A . Neutrophil Lymphocyte Ratio and Cardiovascular Disease Risk: A Systematic Review and Meta-Analysis. Biomed Res Int. 2018; 2018:2703518. PMC: 6252240. DOI: 10.1155/2018/2703518. View

2.
Ma J, Yin J, Qian Y, Wu Y . Clinical characteristics and prognosis in cancer patients with COVID-19: A single center's retrospective study. J Infect. 2020; 81(2):318-356. PMC: 7194544. DOI: 10.1016/j.jinf.2020.04.006. View

3.
Lagunas-Rangel F . Neutrophil-to-lymphocyte ratio and lymphocyte-to-C-reactive protein ratio in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis. J Med Virol. 2020; 92(10):1733-1734. PMC: 7228336. DOI: 10.1002/jmv.25819. View

4.
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J . Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020; 323(11):1061-1069. PMC: 7042881. DOI: 10.1001/jama.2020.1585. View

5.
Wei Y, Wang R, Zhang D, Tu Y, Chen C, Ji S . Risk factors for severe COVID-19: Evidence from 167 hospitalized patients in Anhui, China. J Infect. 2020; 81(1):e89-e92. PMC: 7162743. DOI: 10.1016/j.jinf.2020.04.010. View